Taunton police warn of effects of potent new painkiller Zohydro ER

TAUNTON — Police Chief Edward Walsh said his department is busy enough keeping up with the steady stream of heroin overdoses in the city.

And he says the last thing he needs is the introduction of a powerful new prescription painkiller to the local black market.

“It hasn’t hit the streets yet, but my fear is it has the potential to be as big a problem as Oxycontin,” he said.

Walsh said he’s concerned about the arrival of Zohydro ER, a long-term opioid pain treatment that some are calling “heroin in a pill form.”

The hydrocodone-based Zohydro was approved last October by the U.S. Food and Drug Administration.

Zogenix, the California company that manufactures the pill, said it is “now available to select pharmacies,” according to an email sent to the Taunton Daily Gazette from FDA spokeswoman Julie Normart.

So far neither the Taunton CVS on Washington Street nor the Rite Aid at 237 Broadway are carrying Zohydro, according to pharmacy employees who spoke on the phone Saturday.

But Walsh said it’s only a matter of time before doctors, and possibly even dentists, are writing prescriptions for the drug.

He said that can be bad news in terms of heroin abuse, because of the trend of many drug abusers who switch from expensive pain pills to cheap heroin.

Walsh pointed to the fact that regulators at the FDA disregarded the advice of one of their own advisory committees, which voted 11-2 against approving Zohydro.

A total of 28 state and territorial Attorneys general, including Massachusetts and Guam, submitted a letter to FDA Commissioner Margaret Hamburg in December, asking that the FDA either reconsider approval of Zohydro ER or “sets a rigorous timeline” for it to be “reformulated to be abuse-deterrent.”

Zohydro, the letter states, not only is the first hydrocodone-only opioid narcotic that is possibly five to 10 times more potent than traditional hydrocodone products, it also lacks abuse-deterrent properties.

Walsh points out that so-called abuse deterrents like acetaminophen — which the painkiller Vicodin contains — produces unpleasant side effects for anyone who crushes a pill for either snorting or injection purposes.

The attorneys general received a response in early January in the form of a letter from FDA Deputy Commissioner Sally Howard. She noted that the benefits of Zohydro outweigh its risks “even though the product does not have abuse-deterrent properties.”

She also noted that Zohydro will be subject to stringent controls. As a Schedule II controlled substance, she wrote, it can only be dispensed through a physician’s written prescription for which no refills are allowed.

A statement issued by Zogenix Inc. says Zohydro is acetaminophen-free because long-term use of that ingredient, in high doses over long periods of time, has the potential to cause liver damage.

Walsh said he doesn’t have a problem with the legitimate availability of prescription painkillers.

“The past 20 to 30 years doctors have been treating the whole body as part of pain management, and that’s a good thing.”

But he said there’s always the potential for an increase of robberies of drug stores once it becomes known they are carrying Zohydro.

He also said some drug abusers, if they have to, will “shop out of state” for doctors who more lax in prescribing narcotic painkillers.

Walsh said he’ll eventually discuss potential problems associated with Zohydro with his officers but said it would be “premature” to do so now.

Overdosing on painkillers, he said, is a far rarer occurrence than a heroin-related overdose. Walsh said it’s more likely that someone who manages to overdose on a painkiller is suicidal.

Kate Brauneis, director of Taunton’s Habit OPCO methadone clinic, said so far Zohydro has not been a topic of discussion amongst her staff.

Brauneis said she’ll just have to “wait and see what happens” after Zohydro hits the market in terms of creating greater demand for methadone by users who eventually switch to cheap, but dangerously strong, heroin.

She also noted that she and others in her professional field have noticed during the past five years that some doctors, as a result of tougher controls, have either stopped prescribing oxycodone-based painkillers or closed down their practices.

“We’ll have to wait and see if they decide to prescribe it (Zohydro),” she said.